There are many levels of foot deformities. Often times in a child we want the foot to complete development prior to correcting flatfoot, so most of the procedures that we have designed for pediatric flat foot correction are designed to reposition the foot so that the normal growth can be adjusted in a more corrected position.
So instead of perhaps cutting the bone or fusing a joint, what we will do is we can apply an implant within a joint that can be removed at a later date. This puts the foot in a more corrected position that allows the bones and the tendons, as the child completes his or her growth, to grow in a more corrected position.
And the goal is when they reach the age of osseous or bone maturity, which is usually around the age of 16 to 18, then these implants can be removed and hopefully the deformity has completely been resolved or it has become more functional and manageable at that point but not require any additional surgery.
In these cases, if a child has a flatfoot we usually don’t use fusions unless the child reaches the age of bone maturity after the age of 18. But prior to that age, we can apply soft tissue manipulation, tendon releases or transfers to correct some of the foot deformities.
Can kids outgrow flat feet?
They usually don’t outgrow flatfoot. If it’s diagnosed property, a flatfoot is usually something that will become more severe. Kids can outgrow positional things with their feet and that is why we usually don’t cut into the joints of the foot.
There are cases where we use the growth of the bone to actually assist in correcting the deformities. So we usually try to allow the growth of the bone to actually see how severe the deformity is because things do change in the foot.
While I wouldn’t say they outgrow the deformity, the deformity will change as they grow and to be clear on how severe or how significant that deformity is, we have to wait until the growth is complete or sometimes we use that growth to alter or change the development of the foot in a more corrected position.
There are procedures that we can use where we alter the growth of one side of the bone as the bone continues to grow on the other side therefore we correct the bunion. Because as the bone grows it grows differently in different lengths on either side of the bone, from right to left or left to right, and that has been shown to correct a bunion from the time we do surgery at say 8 to 10 years old to 16 to 18 years old when the child finishes growing and it may prevent any further surgery or the need of that surgery.
Is it normal for toddlers to have flat feet?
The foot is more flexible at a young age. The foot may appear to be flat, but you cannot classify a food as flat unless you take an x-ray of the osseous structures of the foot.
So what appears to be flat because the foot is more flexible a lot of times at that age, a lot of the bones are not finished developing or even appear in the foot yet so the foot may appear to be more flat. Therefore what you’re seeing is not actually a flat foot it’s a more flexible foot.
That’s why we don’t usually operate at young children at this age. We allow the bone structure to complete development and the soft tissue to become more strong and more rigid so that and get past the age where the foot is more flexible … and you’re not seeing the actual structure of the foot at that point.
So it is normal for the foot to appear that it is flat because usually at that age the child is more flexible.
Can flat foot be treated?
Yes, it can be treated a number of ways. It can be treated by the control of the motion of the foot through an orthotic or bracing devices if it is painful more than 50% of the time at a 5-10 pain threshold.
If it requires surgery, then we can manipulate bones, we can fuse bones, we can manipulate tendons without fusing the bones to put the foot back into a more corrected position.
What can pes plansus lead to?
Pes planus is flat foot so it can lead to pain. A limited ability to walk or a decreased ability to ambulate so it can make walking difficult or a person may be limited in the pace and speed the strength in their gait may weaken. Those are some of the results of uncontrolled pes planus.
You can control pes planus or flat foot with orthotics or bracing devices and limit the effects of this foot condition and even at sometimes strengthen the gait without structurally or surgically changing the foot condition.
What is a flexible flat foot?
When standing the foot appears to be very flat and deformed. However, when the patient is off of the foot we can manipulate the foot, whether standing or sitting, into a corrected position.
For example, we can take the foot away from the centerline of that particular leg and the body and it can be moved back to within the centerline of the leg and the progression of the body by just simple either active motion from the patient or external forces from someone moving the foot, which we call that reducible.